Smoking and mental health - NCSCT

Smoking among people with mental disorders 2
the GHQ-12 the proportion was 7%, in those currently taking a psychoactive
medication 14%, and in those who also reported a longstanding mental health
condition 17% (Fig 2.3). Similar observations apply in APMS data (Table 2.6),
which show a particularly high prevalence of heavy addiction among those with
obsessive–compulsive disorder and probable psychosis.
2.7 Association between cigarette consumption and mental
disorders
We examined whether HSE and APMS data support previous reports of an
association between dependence on tobacco and severity of mental disorder. 1,3
Table 2.7 shows the proportion of HSE and APMS participants grouped by
smoking status and daily cigarette consumption who meet the case definition
criteria for the available measures of mental disorder. As can be seen, smokers are
much more likely to have a mental disorder than never smokers and, in most
cases, ex-smokers. In general, the greater the number of cigarettes smoked per
day, the higher the prevalence of mental disorder in that group.
Figure 2.4 shows smoking status and daily cigarette consumption in APMS
participants grouped by CIS-R score, and also demonstrates a clear
dose–response relationship between the severity of mental disorder (indicated by
CIS-R score) and smoking behaviour. The higher the CIS-R score the greater the
proportion of participants who are smokers, and the higher the average daily
cigarette consumption.
2.8 Proportion of cigarettes smoked by people with a mental
disorder
Previous analysis of APMS data suggested that 42% of all cigarettes consumed in
England are smoked by people with a mental disorder. 9 However, this analysis
used an inclusive definition of mental disorder, and included people with a
dependence on alcohol or illicit drugs, those with problem gambling and those
who had made a suicide attempt in the past year. Using the less inclusive
definition of mental disorder used throughout this report, 33% of all cigarettes
are smoked by people with a mental disorder. The majority of these, 29% of all
cigarettes, are smoked by people with a common mental disorder who scored
12+ on the CIS-R.
2.9 Quitting behaviour
Although people with mental disorders are more likely to be smokers and more
likely to be heavily addicted to cigarettes than those without, data from the HSE
© Royal College of Physicians 2013 29